title: Systems for long-segment percutaneous spinal fixation: technical feasibility for various indications.
abstract: BACKGROUND
  New methods of spinal percutaneous fixation are developing very rapidly. However, few studies to date have focused on long-segment methods of instrumentation.
  
  
  OBJECTIVE
  To report the technical feasibility of long-segment percutaneous stabilization for various indications.
  
  
  METHODS
  The study included 24 patients with a mean age of 58 years (range 38-79). The etiologies included trauma, infection, tumors, or pathology secondary to degenerative lumbar scoliosis. The damaged vertebrae ranged from T5 to L4. All of the patients underwent posterior percutaneous long-segment fixation. When necessary, the anterior spinal column was stabilized by balloon kyphoplasty or via anterior approach. The results obtained were analyzed on the basis of clinical and radiological criteria.
  
  
  RESULTS
  The constructs involved four levels on average per patient, located between T3 and S1. No extra-pedicular misplacements were observed. Two technical difficulties were noticed without clinical consequences. A significant improvement in the pain levels was obtained in all the patients in this series.
  
  
  CONCLUSIONS
  Long-segment percutaneous fixation was found to be technically feasible and to considerably improve the patients' spinal deformations. When associated with balloon kyphoplasty, this intervention seems to provide less loss of correction than previous methods, and posterior fusion was therefore not required. As with all new methods, there is a learning curve, and the indications have to be strictly observed. Further studies need to be performed, however, with a longer follow-up to confirm the absence of long-term complications.
authors.affiliation: Université de la Méditerranée, Service d'orthopédie, CHU Nord, Marseille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Blondel
authors.forename: Stéphane
authors.initials: S
authors.lastname: Fuentes
authors.forename: Patrick
authors.initials: P
authors.lastname: Tropiano
authors.forename: Pierre
authors.initials: P
authors.lastname: Roche
authors.forename: Philippe
authors.initials: P
authors.lastname: Métellus
authors.forename: Henry
authors.initials: H
authors.lastname: Dufour
mesh_terms: D006801:Humans; D016268:Internal Fixators / Q000592:standards*; D007593:Joint Instability / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data*; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures / Q000009:adverse effects*